The $62.5 million expansion of Alamance Regional Medical Center is only one Burlington City Council vote away from breaking ground.

Since the city’s Planning & Zoning Commission unanimously recommended the hospital’s rezoning request last week, ARMC is just waiting on council’s OK on Dec. 18 before hauling out the heavy machinery.

“We are on time and we are on budget,” said Dick Donahey, senior vice president of ARMC.

In May, the hospital announced plans to add on to its emergency department and operating services at the north end of campus, and adding a two-story extension to the Medical Arts building to the south, essentially creating a brand new cancer center.

However, before construction could begin, ARMC needed its whole campus rezoned, since an ordinance change in 2003 rendered it an “legal, nonconforming use,” said David Beal, Burlington’s assistant planning director.

Originally, Beal said, the hospital’s property was zoned as “Office and Institutional,” and the ARMC buildings were approved by special-use permits. The 2003 ordinance change called for hospitals to be approved by conditional zoning only.

“You cannot expand a nonconformity,” Beal said.

The hospital requested “Conditional Office and Institutional” rezoning for its whole property — both to bring current structures in compliance and to move forward with expansions.

Assuming council gives its approval, construction on both ends of the hospital will begin in January and hopefully wrap up by early 2014, said Bill Payne, director of engineering at ARMC. The two-story north end addition will house the expanded Emergency Department on its first floor and the Operating Services on the second floor.

The extra space will allow for a total of 58 rooms, which will be divided by type to serve the most pressing emergencies, keep unadmitted patients under observation, or securely keep behavioral patients waiting to be transported to other facilities for long-term care.

“Roughly 60 to 80 percent of our inpatient admissions come through that Emergency Department,” said Donahey.

Annually, 58,000 patients go through the department and a projected 70,000 will visit by 2021. “We’re sizing it for tomorrow,” Payne said.

“Since we’re doubling the size of our space, we have to pretty much double our parking,” Donahey added.

An additional lot for Emergency Department parking will also be built.

The second floor of the addition will house the expanded Operating Services, where major and minor surgeries are performed, he said.

“We have nine operating rooms now, and we can’t expand that,” Payne said, explaining the state dictates the number of operating rooms a hospital can have. So instead of making more rooms, the existing nine operating rooms will be made larger.

Page 2 of 2 - Payne said the building add-on will hold five new operating spaces, and then rooms six through nine will be rebuilt in existing building space. He said same-day surgery space will also be doubled and all operating rooms will be digital or digital-ready.

At the other end of campus, another two-story addition will expand ARMC’s existing Cancer Center, giving patients more options and an improved atmosphere. The addition’s first floor will have a community and educational area at the front, near a new patient entry, as well as radiation exam and therapy rooms.

Up the spiral staircase will be the oncology exam rooms, physician and research offices and a chemotherapy treatment area with bay windows.

“The design was to bring in as much natural light … as possible,” Payne said.

In the larger treatment area, which will overlook a “healing garden,” chemotherapy patients will have the options of receiving treatment in an open, group setting, semi-private or private rooms, Payne said.

The construction will take place in stages. Payne said the plan is to build the Emergency Department and Operating Services addition in eight months, with builders working two shifts, six days a week.

“We’re double-timing it,” he said.

Once built, Payne said everything in the old spaces will be moved into the new addition, to allow for a four-month renovation of the original building. The Cancer Center addition has a 12-month timeline and will be under construction simultaneously.

Work will begin immediately after the holidays if approval from the city comes later this month as anticipated.

Then, Donahey said, “Construction fences will go up Jan. 3 and we will start moving dirt.”